Six Minutes Can Make a Difference for Patients

Laura Cruwys’ last hope of receiving a lung transplant rested on her ability to walk continuously for six minutes on a flat surface.

“Walking for that period of time doesn’t seem like much, but for patients who are awaiting a lung transplant, it can mean the difference between being on the donor waiting list or being removed from it,” said Priscilla Perruzzi, RRT, clinical supervisor of the Pulmonary Rehabilitation Program.

Every year, hundreds of patients undertake this six-minute walk at BWH under the watchful eyes of staff from the Pulmonary Rehabilitation Program or Pulmonary Function Lab to determine whether they are strong enough to undergo lung transplantation. As one of the many requirements lung transplant candidates must meet to be placed and stay on the waiting list, patients must complete the walk every six months to ensure their lungs have not deteriorated.

The test consists of a patient walking as far as possible for six minutes on a flat surface; sometimes patients walk back and forth in a measured hospital hallway. They are allowed to slow down, stop and rest as respiratory therapists monitor their breathing patterns and blood oxygen level.

Respiratory therapists play a vital role by encouraging patients and mentally preparing them. Often, patients are too sick to complete the task and can become short of breath or exhausted. If a patient fails to complete the walk, he or she can try it another day.

“Most of the time, you have to be like a coach,” said Noel Moreno, MS, RRT, RPFT, respiratory therapist and clinical coordinator of the PFT Service, who supervised Cruwys’ walk.

Cruwys was diagnosed as an infant with cystic fibrosis, a life-threatening genetic disease that causes mucus to build up in some of the organs in the body, particularly the lungs and pancreas. Last June, the 31 year old awoke one morning unable to breathe. With her condition deteriorating fast, she was transferred to BWH in need of a life-saving double lung transplant and admitted to the MICU, where she needed intubation and underwent a tracheostomy.

Paulette Downs, RRT, MICU respiratory therapist, was also with Cruwys when she performed the test while on a portable ventilator, something that is extremely taxing on a patient's body. “She was weak physically, but her level of optimism and resilience never let up,” said Downs. “She kept charging forward and didn’t give up.”

Two days after completing the walk, a match was found for Cruwys. She received her double-lung transplant in August. Today, she is feeling healthy and hopes to return to work part-time as a cake decorator soon.

“I have always enjoyed decorating cakes and, thanks to a donor and the care I received at BWH, I’ll be back at it very soon,” Cruwys said.